Individual
MS. MEGAN WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
67 PRESIDENT ST, MSC 861, IOP 2 SOUTH, CHARLESTON, SC 29425-5712
(843) 792-8209
(843) 792-3388
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
11288
SC
Other
Enumeration date
06/22/2015
Last updated
06/23/2015
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